Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
J Allergy Clin Immunol. 2011 Dec;128(6):1198-1206.e1. doi: 10.1016/j.jaci.2011.08.037. Epub 2011 Oct 13.
Chronic rhinosinusitis (CRS) with nasal polyps is an inflammatory condition of the nasal passage and paranasal sinuses characterized by T(H)2-biased inflammation with increased levels of B-cell activating factor of the TNF family (BAFF), B lymphocytes, and immunoglobulins. Because high levels of BAFF are associated with autoimmune diseases, we assessed for evidence of autoimmunity in patients with CRS.
The objective of this study was to investigate the presence of autoantibodies in sinonasal tissue from patients with CRS.
Standardized nasal tissue specimens were collected from patients with CRS and control subjects and assayed for immunoglobulin production, autoantibody levels, tissue distribution of immunoglobulins, and binding potential of antibodies in nasal tissue with a multiplexed autoantibody microarray, ELISA, and immunofluorescence.
Increased levels of several specific autoantibodies were found in nasal polyp tissue in comparison with levels seen in control tissue and inflamed tissue from patients with CRS without nasal polyps (P < .05). In particular, nuclear-targeted autoantibodies, such as anti-dsDNA IgG and IgA antibodies, were found at increased levels in nasal polyps (P < .05) and particularly in nasal polyps from patients requiring revision surgery for recurrence. Direct immunofluorescence staining demonstrated diffuse epithelial and subepithelial deposition of IgG and increased numbers of IgA-secreting plasma cells not seen in control nasal tissue.
Autoantibodies, particularly those against nuclear antigens, are present at locally increased levels in nasal polyps. The presence of autoantibodies suggests that the microenvironment of a nasal polyp promotes the expansion of self-reactive B-cell clones. Although the pathogenicity of these antibodies remains to be elucidated, the presence of increased anti-dsDNA antibody levels is associated with a clinically more aggressive form of CRS with nasal polyps requiring repeated surgery.
伴有鼻息肉的慢性鼻-鼻窦炎（CRS）是一种鼻腔和鼻窦的炎症性疾病，其特征为 T(H)2 偏向性炎症，B 细胞激活因子肿瘤坏死因子家族（BAFF）、B 淋巴细胞和免疫球蛋白水平升高。由于 BAFF 水平升高与自身免疫性疾病相关，我们评估了 CRS 患者是否存在自身免疫证据。
本研究旨在探讨 CRS 患者鼻黏膜组织中是否存在自身抗体。
收集 CRS 患者和对照者的标准化鼻组织标本，采用多重自身抗体微阵列、ELISA 和免疫荧光法检测免疫球蛋白产生、自身抗体水平、免疫球蛋白在组织中的分布以及鼻组织中抗体的结合潜能。
与对照组织和无鼻息肉的 CRS 患者的炎症组织相比，鼻息肉组织中发现几种特定自身抗体水平升高（P ＜.05）。特别是核靶向自身抗体，如抗双链 DNA IgG 和 IgA 抗体，在鼻息肉中水平升高（P ＜.05），尤其是在需要再次手术以治疗复发的鼻息肉中。直接免疫荧光染色显示 IgG 弥漫性上皮和上皮下沉积以及 IgA 分泌浆细胞数量增加，而在对照鼻组织中未见这些现象。
自身抗体，特别是针对核抗原的自身抗体，在鼻息肉中局部水平升高。自身抗体的存在表明鼻息肉的微环境促进了自身反应性 B 细胞克隆的扩增。尽管这些抗体的致病性尚待阐明，但抗 dsDNA 抗体水平升高与需要重复手术的临床侵袭性更强的 CRS 伴鼻息肉有关。
